Captain Name *

First Name

Last Name

Captain Phone *

(###)

###

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Liability Waiver *

I hereby acknowledge that I have voluntarily and freely elected to participate in this Kickball Tournament and that I am not required to do so. I understand and agree that The Remnant Church and/or its representatives assume no liability in the event of accident or illness, nor for damage or injury to person or property of any nature whatsoever, including but not limited to as a result of any omissions or acts of negligence. I voluntarily and freely assume all risk of accident, injury, illness or damage to or loss of property. The Remnant Church and/or its representatives shall not be responsible to any person for any of my acts or omissions. I agree to release, indemnify, and hold harmless The Remnant Church and/or its representatives from and against any claim in which my team, of any other person or I may have for any losses, damages, or injuries arising out of or in connection with my participation in the Remnant Kickball Tournament.

I agree and consent to the above

Team Registration Payment *

Team registration cost of $180 to be made after submission (Pastor Blake will be in contact with the Team Captain). Early-bird special of $150 available for the first 4 teams to register (not guaranteed, based on timing of team registrations).

I agree and consent to the above